Graves matter: Hyperthyroidism causes tremors, eye woes

Hip-hop star Missy Elliott and Mrs. Barbara Bush have something in common. No, it isn’t their jewelry: Missy doesn’t wear those big fake pearls for which Barbara has been so famous. And no, Barbara hasn’t performed on stage with Madonna and Britney Spears French-kissing. And no, they aren’t working on a venture album, Supa Dupa Fly II.  What they have in common is Graves disease.

Is this thyroid problem grave?

Elliott boom-boxed in People Magazine June 2011 that she has has had Graves disease since 2008. This autoimmune disease can overstimulate the thyroid and cause eye problems, among other things. Elliott said she almost crashed her car because she couldn’t use the brakes due to tremors. A person might incorrectly attribute such tremors to anxiety.

The overactive thyroid can cause anxiety and poor sleep, which leads to fatigue. You'd think the excessive thyroid hormones would create more energy, but, in fact, the jitters can make the hyperthyroid person feel like she's doing the jitterbug 24-7. Olympic multi gold-medalist Gail Devers' bout with Graves disease was a huge hurdle before she found out what was causing her problems.

Because the metabolism speeds up, weight loss is common. However, some folks get so apathetic that they gain weight from becoming couch potatoes.

I have always been hot– no, not Hugh Jackman “hot.” I used to sweat just looking at the calendar’s summer months. When I became hypothyroid (low thyroid— the opposite of Graves' hyperthyroidism), I often felt cold until I got treated. On the other hand, hyperthyroidism makes folks feel hot and sweaty, like Snooki on Jersey Shore.

Brittle hair, hair loss, and menstruation irregularities can also occur, which happened to me when I heard Snooki was paid $2,000 more than Nobel Prize winner Toni Morrison when they appeared at Rutgers University this year.

If your eyes are popping with that piece of information, about 25 percent of folks with Graves disease have eye problems. Have you noticed how Barbara Bush’s eyes seem to pop out of their sockets? Swelling causes the eyeballs to extrude so the person with Graves might appear to be very interested in you or very surprised.  Because the eyelids are stimulated opened, you can see the whites of their eyes above and below the iris.

Though not all cases of Graves disease result in hyperthyroidism (e.g. only the eyes might be involved), a goiter usually results when the thyroid is involved. A goiter is an enlarged thyroid that makes it look like you swallowed a softball, and it's lodged in the lower throat.

A tense kind of leg swelling can result to make a pretty lady upset about her new cankles. Notice I mentioned a lady because Graves disease afflicts 10 times as many women as men! Perhaps Graves disease is a result of estrogen or the X chromosome. Many cases of Graves occur within twelve months after pregnancy.

So the answer is yes, Graves disease is grave if left untreated. Diagnosis is made by a simple blood test and clinical evaluation by an endocrinologist. Treatment with radiation or surgery on the thyroid can be very successful to combat the hyperthyroidism. Anti-thyroid medicines are alternatives although they don't cure the disease, as evidenced by the fact that Barbara Bush had a small relapse in March 31, 2010.
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Dr. Hook cracks a joke or two, but he's a respected physician with an interesting website, drjohnhong.com. Email him your questions.